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By Robert PearTHE NEW YORK TIMES • Friday February 14, 2014 6:58 AM

WASHINGTON — One in 5 people who signed up for insurance under the new health-care law failed to
pay their premiums on time and therefore did not receive coverage in January, insurance companies
and industry experts say.

Paying the first month’s premium is the final step in completing an enrollment. Under federal
rules, people must pay the initial premium to have coverage take effect.

In view of the chaotic debut of the federal marketplace and many state exchanges, the White
House urged insurers to give people more time, and many agreed to do so. But, insurers said, some
people missed even the extended deadlines.

Lindy Wagner, a spokeswoman for Blue Shield of California, said 80 percent of the people who
signed up for its plans had paid by the company’s Jan. 15 due date. Blue Shield has about 30
percent of the exchange market in the state.

Matthew N. Wiggin, a spokesman for Aetna, said about 70 percent of people who signed up for its
health plans paid their premiums. For Aetna policies taking effect on Jan. 1, the deadline for
payment was Jan. 14, and for products sold by Coventry Health Care, which now is part of Aetna, the
deadline was Jan. 17.

Mark T. Bertolini, the chief executive of Aetna, said last week that the company had 135,000 “
paid members,” out of 200,000 who began to enroll through the exchanges.

“I think people are enrolling in multiple places,” Bertolini said in a conference call with
securities analysts. “They are shopping. And what happens is that they never really get back on
HealthCare.gov to disenroll from plans they prior enrolled in.”

Kristin E. Binns, a vice president of WellPoint, one of the nation’s largest insurers, said that
76 percent of people selecting its health plans on an exchange had paid their share of the first
month’s premium by the due date of Jan. 31.